Cognitive status of prostate cancer (PCa) patients aged 60 years and older initiating gonadotropin-releasing hormone agonist (GnRHa) therapy, by age group.

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74 Background: Age is a risk factor for both PCa and cognitive impairment. Moreover, androgen deprivation therapy (ADT) is suspected to alter cognition, but little is known about the cognitive status of men starting ADT. Our purpose was to analyze cognitive status in 3 groups of age ([60-70[, [70-75[ and ≥ 75 years). Methods: Initiated in March 2018, a prospective, multicenter, longitudinal, non-interventional study is conducted in France (PRISME, NCT03516110). Urologists, radiation oncologists and medical oncologists recruited patients aged 60 years and older, with histologically confirmed PCa, candidate for GnRHa therapy. Patients were included (1:2:1) in prespecified age groups ([60-70[, [70-75[, ≥ 75 years). Cognitive status was evaluated through Mini Mental State Evaluation (MMSE) questionnaire (scores 0-30), and through a visual analog scale (VAS) measuring satisfaction of patients with memory (score 0-10 cm). Significant differences (*) were concluded in case of non-overlapping of the means 95% CIs. Results: 528 patients were included in the pre-planned interim analysis of baseline results. Mean (±SD) age was 72.9±6.5years. There were 145, 207 and 176 patients, in the [60-70[, [70-75[ and ≥75y age groups, respectively. 93.8% of patients had a Karnofsky score ≥ 80%; 73.4% had at least one comorbidity at baseline and 67.9% were receiving at least one concomitant systemic treatment. Reason for GnRHa initiation was high risk localized or locally advanced tumor (57.6%), metastatic stage (19.8%), biochemical recurrence after local treatment (14.7%). Mean [95% CI] MMSE score was significantly* lower in the ≥75y age group (26.1 [25.5-26.8]) than in the [60-70[ (27.6 [27.0-28.1]) and [70-75[ (27.5 [27.1-28.0]) age groups. Cognitive impairment (MMSE < 26) concerned 18.2%, 17.6% and 32.0% of patients, respectively. Similarly, memory VAS mean score was significantly* lower in the ≥75y age group (6.4 [6.0-6.8]) than in the [70-75[ age group (7.2 [6.9-7.5]). Conclusions: Analysis of the cognitive status of 3 age groups at initiation of GnRHa therapy showed a higher rate of cognitive impairment in the eldest group. Clinical trial information: NCT03516110.